{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:51:47Z","timestamp":1791532307922,"version":"4.3.4"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Dental Education"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n The current financing model for US dental education is increasingly misaligned with the goals of sustainability, equity, and workforce design. Tuition has risen substantially over time, educational debt among dental graduates remains high, and evidence suggests that price affects enrollment decisions and student diversity. High debt may also constrain career choice, reducing graduates\u2019 flexibility to pursue academic, hospital\u2010based, public\u2010serving, and safety\u2010net careers. At the same time, major reform reports across the past century have repeatedly argued that dental education must periodically redesign its structure, financing, and institutional role in response to changing social needs and health systems. These concerns informed the deliberations of Working Group 2 (WG2) at the Reimagining Dental Education Summit in June 2026.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To present a perspective with consensus recommendations from WG2: Student debt, sustainability, and pathway reform on structural reforms that could reduce tuition dependency in dental education while preserving educational quality, professional accountability, and public mission.<\/jats:p>\n <\/jats:sec>\n \n Consensus Process<\/jats:title>\n WG2 used a structured worksheet, facilitated discussion, and iterative review of background materials, including studies on price sensitivity, educational debt, return on investment, workforce trends, and healthcare educational debt, together with summit materials that articulated bold reform concepts. Recommendations were refined across working sessions and advanced through the final report\u2010out process.<\/jats:p>\n <\/jats:sec>\n \n Recommendations<\/jats:title>\n The group reached consensus on four recommendations: (1) Shorten and restructure the dental education pathway around competency and a paid transition year; (2) create technology\u2010enabled shared curricula and preclinical training models; (3) implement pledge\u2010based and pay\u2010it\u2010forward financing models; and (4) modernize licensure, accreditation, and regulatory frameworks to support new educational pathways.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Dental education's affordability challenge is not solely a debt problem as it is a structural design problem. Reducing tuition dependency will require redesign of educational pathways, institutional cost structures, and regulatory frameworks so that access to the profession is determined more by talent and commitment than by financial capacity.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jdd.70400","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:45:07Z","timestamp":1791531907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Removing Tuition Dependency From Dental Education: Consensus Recommendations on Student Debt, Sustainability, and Pathway Reform"],"prefix":"10.1002","author":[{"given":"Shelyn A.","family":"Yamakami","sequence":"first","affiliation":[{"name":"Harvard School of Dental Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Reddy","sequence":"additional","affiliation":[{"name":"School of Dentistry University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University School of Dentistry Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ali","family":"Shazib","sequence":"additional","affiliation":[{"name":"High Point University Workman School of Dental Medicine High Point North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desmond","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Arizona School of Dentistry & Oral Health, A.T. Still University Mesa Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Quinn","sequence":"additional","affiliation":[{"name":"Restorative Dentistry & Dental Education University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Beneduce","sequence":"additional","affiliation":[{"name":"New York University College of Dentistry New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Miranda","sequence":"additional","affiliation":[{"name":"California Northstate University College of Dental Medicine Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang E.","family":"Park","sequence":"additional","affiliation":[{"name":"Harvard School of Dental Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"American Dental Association Health Policy Institute \"Commission on Dental Accreditation Surveys of Dental Education United States. Group II: 2025\u201326 \"American Dental Association 2026 https:\/\/www.ada.org\/resources\/research\/health\u2010policy\u2010institute\/dental\u2010education."},{"key":"e_1_2_11_3_1","unstructured":"E. C.Istrate C. L.Booker A.Samanta andK. P.West \u201cDentists of Tomorrow 2025: An Analysis of the Results of the ADEA 2025 Survey of U.S. Dental School Seniors \u201d American Dental Education Association 2026 https:\/\/www.adea.org\/docs\/default\u2010source\/adea\u2010main\/research\u2010publications\/dental\u2010school\u2010seniors\/adea_dentists_of_tomorrow_2025.pdf?sfvrsn=3538f41_4."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.21815\/JDE.017.004"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.21815\/JDE.018.109"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jdd.12584"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909\u2010023\u201004634\u20101"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.0022\u20100337.2008.72.2_suppl.tb04475.x"},{"key":"e_1_2_11_9_1","volume-title":"Dental Education at the Crossroads: Challenges and Change","author":"Institute of Medicine, Committee on the Future of Dental Education","year":"1995"},{"key":"e_1_2_11_10_1","volume-title":"Oral Health in America: A Report of the Surgeon General","author":"U.S. Department of Health and Human Services","year":"2000"},{"key":"e_1_2_11_11_1","volume-title":"Dental Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching","author":"Gies W. J.","year":"1926"},{"key":"e_1_2_11_12_1","first-page":"37","volume-title":"Leadership for the Future: The Dental School in the University","author":"Hendricson W. D.","year":"1999"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.0022\u20100337.2005.69.10.tb04008.x"},{"key":"e_1_2_11_14_1","volume-title":"Beyond the Crossroads: Change and Innovation in Dental Education","author":"ADEA Commission on Change and Innovation in Dental Education","year":"2009"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jdd.12191"}],"container-title":["Journal of Dental Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jdd.70400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jdd.70400","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jdd.70400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:45:10Z","timestamp":1791531910000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jdd.70400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":14,"alternative-id":["10.1002\/jdd.70400"],"URL":"https:\/\/doi.org\/10.1002\/jdd.70400","archive":["Portico"],"relation":{},"ISSN":["0022-0337","1930-7837"],"issn-type":[{"value":"0022-0337","type":"print"},{"value":"1930-7837","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]},"assertion":[{"value":"2026-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jdd.70400"}}